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Individual
MR. JOHN KELLY
Active
Individual
MR. JOHN KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Taxonomy
Speciality
Code
Description
License number
State
363LX0106X
Occupational Health Nurse Practitioner
Primary
425362
CA
Other
Enumeration date
09/01/2016
Last updated
09/01/2016
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